President warns Texas that massive resistance to Obamacare implementation will hurt residents

President Obama responds to a question at his April 30 press conference. (Rick Dunham / Houston Chronicle)

President Obama said massive resistance from states including Texas has complicated efforts to implement to his signature health-reform law.

“It’s harder,” Obama said at a White House press conference today. “There’s no doubt about it.”

States including Texas have refused to create their own “exchanges” to offer lower-cost health insurance options for uninsured residents. The 2010 health-reform law requires the federal government to create substitute “exchanges” if states refuse.

Responding to a question about Texas and Florida, Obama said the states’ resistance creates additional work for federal officials and hurts residents in those states.

“We will implement it,” he vowed. “There will be — we have a backup federal exchange. If states aren’t cooperating, we set up a federal exchange so that people can access that federal exchange.”

Obama says he finds it “ironic” that state politicians who often complain about Washington-dictated solutions have decided to cede their decision-making power to federal officials in Washington.

“Yes, it puts more of a burden on us,” he said. “And it’s ironic, since all these folks say that they believe in empowering states, that they’re going to end up having the federal government do something that we’d actually prefer states to do if they were properly cooperating.”

In addition to declining to establish the “exchanges,” Texas Gov. Rick Perry and the Texas Legislature have refused to expand Medicaid, despite the federal government’s willingness to pick up 90 percent of the initial cost. Perry says he is unwilling to accept money with strings attached.

The state of Texas unsuccessfully sued to have Obamacare declared unconstitutional.